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Breast Cancer  (Expert Forum)
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How painful is the isotope injection before you go to Lymph node surgery?
Questions posted in the Breast Cancer Forum are answered by medical professionals from The Cleveland Clinic. Topics include Breast Biopsy, Chemotherapy, Hormone Therapy, Lumps, Lumpectomy, Lymph node dissection, Lymphedema, Mammograms, Mastectomy, Radiation Therapy, Reconstruction, Self Breast Exam, and Surgery.

How painful is the isotope injection before you go to Lymph node surgery?

by Latinme, Sep 27, 2004 12:00AM
I read a lot on how painful the injection that the nuclear medicine gave you 8 hours before you go to surgery for the Sentinel Lymph Node biopsy. Please give me an sincere answer. Sometimes I can't tolerate pain. The doctor said they can't give you any pain killer because will affect the test.

by CCF-RN,MSN-JS, Sep 28, 2004 12:00AM
Dear Latinme, In checking with our collegues in Nuclear Medicine who do the injections of the isotopes their experience has been that with this injection there is some stinging as the isotope is injected (this is due to the volume of fluid being injected into the tissue, not because of the isotope itself), the stinging lasts only a short amount of time.  They do 4 injections around the site of the lesion, after first numbing the area.  Everyone has different levels of pain tolerance, however, for the most part this procedure is well tolerated.  After the injections the patient lies on a flat table for about an hour then scans are taken.
Member Comments (13)

by susan m k, Sep 27, 2004 12:00AM
For me, that was the most painful experience of my life.  Why can't a woman be given general anesthesia?  I do not understand this.  Good luck, Susan

by Belleview Teacher, Sep 27, 2004 12:00AM
I had the injections and found it tolerable.  There was some pain, but not to the point of making me cry or want to scream.Also, the pain is very short in duration. You also have to massage the breast to help distribute the material to the nodes. All in all, there was discomfort, but it was bearable.

by Twocapes, Sep 27, 2004 12:00AM
I don't remember any pain.  I had to massage the breast area "before" the injection because they used a numbing gel called Emgel.

by dorisdaughter, Sep 28, 2004 12:00AM
I found the injections (I think 4 separate needles) to be very painful -- though, as anoher commenter pointed out, the worst pain does not last too long (though my breast throbbed during the massaging) which is a good thing, because I can't imagine that pain on a sustained basis.  The radiologist who performed this procedure on me was in a real hurry, barely paid attention to me because she was too busy scolding the tech and also didn't inform me about any pain.  I wrote a letter of compliant about her.  Also, I have been told that the pain factor can be mitigated by the skill/care of the practitioner, so don't be too taken aback by the "painful experience" comments -- you could wind up with minimal pain and obviously it's well worth going through to get the result you need.  Good luck to you.

by Liz S, Sep 28, 2004 12:00AM
I had the wire localization and nuclear injection at the same time and had no pain whatsoever......and know of 3 other women who's experience was the same.  Good Luck.

by ritavv, Sep 29, 2004 12:00AM
Maybe it was the lidocane for the wire localization, but I had no pain with the isotope injection.  I was sitting up while I waited for the scan.  They recommended that I move my arm around to help get the isotope to drain to the node.

by deevee, Sep 29, 2004 12:00AM
To: Latinme
The 2 of the 3 injections were the most painful experience in my life.  I was not given any numbing and I was not prepared for the amount of pain I experienced (my body shook and my eyes teared).  Another lady also voiced her complaint about the pain and radiology started using a topical anesthetic and finally found they could use lidocaine without affecting the effectiveness of the procedure.  (I asked why they hadn't been using a local anesthectic earlier and the answer was that's how they learned the procedure.)  You should not have to go through the procedure without any anesthetic.  I hope your doctor can get updated information on numbing for this procedure.  Good luck!

by Alexis in Virginia, Oct 07, 2004 12:00AM
ask about lidocane and maybe see if you can go somewhere they use it if you have a real problem tolerating pain.  I found it brought some tears to my eyes but mostly because the injections are slow and in a sesitive area and there are 4 of them.  I thought it was painful but tolerable but I do tolerate pain pretty well so it wasn't really an issue for me.  The pain only lasted during the injection and was I was fine afterwards.  At the very least maybe you can take tylenol to help with the discomfort before and after the procedure?  ASk you surgeon as well as the radiologist.

by Anajo, Oct 14, 2004 12:00AM
For me this experience was EXTREMELY painful; I was screaming.  I wish I had been warned in advance and could have applied some Lidocaine or something an hour in advance.  I was given some cream to rub on the area, but I had no idea what was in store for me.

by kasey10, Oct 29, 2004 12:00AM
it has been almost 2 years since I had that procedure and just reading your responses to the pain aspect of it makes it very clear that the training the technicians receive is far from

consistent. Some of you were permitted some type of numbing agent. Some were not. Some were allowed to sit up and others required to lie down. Some were advised to massage the breast to help distribute the isotope solution towards the lymph nodes. Others were told nothing. In my own case, i was not offered any numbing agent.  I was not told to massage the breast. But the two technicians that worked with me were the most compassionate persons I could have asked for. The pain was unbearable. I cried terribly. I seemed to not be able to control my feet from kicking and pleaded with them to please stop. The one administering the injection kept apologizing for the pain. The other kept holding my hand and saying soothing words over and over. I think that women should be asked beforehand about their pain and if they would like something before the procedure. The whole procedure wasn't explained thoroughly beforehand by my surgeon.  But then neither was the stereotactic biopsy my first surgeon performed. I suspect that if they told us everything about these procedures they'd never get us to do them! But training the technicians better and more compassionately would be an improvement for all women unfortunate enough to have to endure these type tests.  In December I will be a two year survivor of breast cancer. It was caught early enough for me to have choices about my treatment. Partly because of these tests.

by Marta500, Oct 29, 2004 12:00AM
Unbelivable pain!!!!!!

I told my surgeon before, I do not want to feel any pain. He was smiling ang gave me Valium., Sad it will be OK.

The radilogist applied cream on my breast, and sad, I will feel pain. I told him NO, I do not want to feel pain, I clearly discuss this with my surgeon.

I had to wait, they called him down from the operating room. When he came down I told him what is going on? He called the anastesioligist to come to radiology, but she refused. Than I told my doctor, cancel the surgery, I will go somewhere else.

Than the ansthesiologist ordered for me Dilaudid tablets. took 1 hr. to get it, because it is a controlled narcoticum, so needed 2 signature. He told me I scrood up the whole hospital scedule,

and I told him, He scrood himself. after a wait of 30 minutes, to let the narcotic work, they started the injections. The 1st was painfull but I was able to tolerate. the 2nd and the 3rd was untolerable, I told them, if the 3rd not working, they can not give me the 4th, I am going home. The 3rd was OK, I did not need the 4th. I was screeming, crying, from anger